Greene, Charlene M

Greene, Charlene M is an individual health care provider with primary practice located at 1010 Olive Ave , Florence WI 54121-0380. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Greene, Charlene M can be contacted via phone (715) 528-4775.

Contact Information

Primary practice address
1010 Olive Ave Florence WI 54121-0380
Phone: (715) 528-4775
Fax: (715) 528-5592
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 42172 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101009102 Michigan

Profile Details

NPI number 1568444313
LBN Legal business name Greene, Charlene M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated May 6th, 2019 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568444313 NPPES
Michigan Other 0852200084 BCBS MI
Michigan Other P00933500 BCBS MI
Michigan MEDICAID 4197165 BCBS MI
Michigan MEDICAID 30096600 BCBS MI

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